{"doi":"10.1370/afm.240331","title":"Neighborhood Determinants of Primary Care Access in Virginia","abstract":"PURPOSE: Primary care is the foundation of any health care system. Primary care improves the health of communities and decreases health inequities. Yet, workforce shortages have worsened in the United States. Understanding characteristics of where workforce gaps are greatest is key to developing effective workforce solutions. METHODS: We used the 2019 Virginia All-Payers Claims Database to identify primary care physicians (PCPs) and the number of distinct patients seen by each physician. These data were used to identify PCP access by census tract measured using an enhanced 2-stage floating catchment method. Guided by the Andersen model of health care utilization, we identified predisposing, enabling, need, and structural community characteristics from public data sources. We assessed associations between PCP access and these characteristics using spatial autoregressive models with lagged independent variables. Analyses were performed from 2023 to 2024. RESULTS: <.001). CONCLUSIONS: There is an inadequate primary care workforce in Virginia. Structural factors, rather than predisposing, enabling, or need factors, contribute most to PCP access. Whereas Black segregated communities might have greater PCP access, rural communities are significantly disadvantaged.","journal":"The Annals of Family Medicine","year":2025,"id":544416,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.7779,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1434601,"name":"Jennifer Hinesley","orcid":"0000-0003-4369-026X","position":1,"is_corresponding":false},{"id":1434602,"name":"Benjamin Webel","orcid":"0000-0001-9879-3608","position":2,"is_corresponding":false},{"id":1317547,"name":"Adam Funk","orcid":"0000-0001-8404-1173","position":3,"is_corresponding":false},{"id":1109452,"name":"Jong Hyung Lee","orcid":null,"position":4,"is_corresponding":false},{"id":1434603,"name":"Scott M. Strayer","orcid":"0000-0002-7879-1311","position":5,"is_corresponding":false},{"id":1025796,"name":"Roy T. Sabo","orcid":"0000-0002-5866-2598","position":6,"is_corresponding":false},{"id":1434977,"name":"Lauryn S. Walker","orcid":null,"position":7,"is_corresponding":false},{"id":1434604,"name":"Michael Topmiller","orcid":"0000-0002-3864-6507","position":8,"is_corresponding":false},{"id":1434605,"name":"Andrew D. Mitchell","orcid":"0000-0001-8399-8563","position":9,"is_corresponding":false},{"id":1434606,"name":"Jacqueline Britz","orcid":"0000-0001-5868-3711","position":10,"is_corresponding":false},{"id":432752,"name":"Andrew J. Barnes","orcid":"0000-0002-0357-3934","position":11,"is_corresponding":false},{"id":384727,"name":"Alex H. Krist","orcid":"0000-0003-4060-9155","position":12,"is_corresponding":false},{"id":1105103,"name":"Hannah Shadowen","orcid":"0000-0003-1939-7311","position":0,"is_corresponding":true}],"reference_count":2,"raw_metadata":null,"created_at":"2026-07-19T02:53:12.864581Z","pmid":"40425466","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}